Infants of diabetic mothers are more likely than infants of nondiabetic mothers to exhibit macrosomia, prematurity, perinatal mortality, and congenital malformations. Offspring of diabetic women are also at an increased risk of developing obesity and glucose intolerance during childhood and young adulthood. The purposes of the project are to determine the effects of diabetes and impaired glucose tolerance during pregnancy on outcome of pregnancy in women in the Gila River Indian Community and to determine long-term prognosis for the women and their offspring. By means of a glucose tolerance test and chart review, the diabetes status of every woman is determined during the third trimester of each pregnancy. The characteristics of women who have diabetes or impaired glucose tolerance during the pregnancy are compared with those of women who are normal in pregnancy and subsequently develop diabetes, and with those of women who remain normal. These women and their offspring are followed, and glucose tolerance tests are performed which include measurements of glucose and insulin. Offspring of diabetic women have more diabetes and more obesity than offspring of nondiabetic and prediabetic women. Fasting hyperinsulinemia, presumably reflecting increased insulin resistance, occurrs at an earlier age in the offspring of women who had abnormal glucose tolerance during pregnancy. Thus, the metabolic abnormalities associated with the diabetic pregnancy result in long-term effects on the offspring including insulin resistance, obesity, and diabetes which in turn may contribute to transmission of risk for developing the same problems to the next generation.